Humalog Basal (Insulin Lispro Protamine)
Intermediate-acting insulin analogue for basal glycaemic control in diabetes mellitus
Quick Facts About Humalog Basal
Key Takeaways About Humalog Basal
- Intermediate-acting basal insulin: Provides background insulin coverage for up to 24 hours, with onset in 1–2 hours and peak effect at 4–12 hours
- Subcutaneous injection only: Humalog Basal must never be given intravenously — it is designed exclusively for subcutaneous administration
- Do not mix in cartridge: Unlike some other insulin formulations, Humalog Basal should not be mixed with other insulins in the same cartridge or syringe
- Hypoglycaemia is the main risk: Regular blood glucose monitoring is essential; patients and carers should recognise and know how to treat low blood sugar
- Resuspend before every injection: The cartridge must be gently rolled and inverted until the insulin appears uniformly cloudy before each use
What Is Humalog Basal and What Is It Used For?
Humalog Basal (insulin lispro protamine) is an intermediate-acting insulin analogue used for the treatment of diabetes mellitus in adults and children who require insulin for the maintenance of normal glucose homeostasis. It provides basal insulin coverage to help control blood sugar levels between meals and during the night.
Humalog Basal belongs to the class of intermediate-acting insulin analogues. Its active ingredient, insulin lispro protamine, is a modified form of human insulin where the amino acid sequence has been altered (lysine and proline transposed at positions B28 and B29) and complexed with protamine to slow absorption from the subcutaneous injection site. This produces a prolonged glucose-lowering effect compared to rapid-acting insulin lispro (Humalog), making it suitable for providing basal insulin coverage throughout the day and night.
The medication is indicated for patients with type 1 diabetes mellitus (where the pancreas produces little or no insulin) and type 2 diabetes mellitus (where the body does not use insulin effectively). In type 1 diabetes, Humalog Basal is typically used as part of a basal-bolus regimen in combination with a rapid-acting insulin at mealtimes. In type 2 diabetes, it may be used alone or in combination with oral antidiabetic agents such as metformin, sulfonylureas, or SGLT2 inhibitors, particularly when oral medications alone do not achieve adequate glycaemic control.
Insulin is one of the most important hormones in the body for regulating blood sugar. In people with diabetes, the body either cannot produce enough insulin or cannot use it properly, leading to chronically elevated blood glucose levels (hyperglycaemia). Over time, uncontrolled hyperglycaemia can lead to serious complications including cardiovascular disease, nephropathy (kidney damage), retinopathy (eye damage), and neuropathy (nerve damage). By providing a steady background level of insulin, Humalog Basal helps maintain blood glucose within a target range and reduces the risk of these long-term complications.
Regular Humalog (insulin lispro) is a rapid-acting insulin taken at mealtimes, with onset within 15 minutes and duration of 2–5 hours. Humalog Basal is an intermediate-acting insulin designed for background coverage, with onset at 1–2 hours, peak at 4–12 hours, and duration up to 24 hours. The protamine complexation delays absorption, giving a longer, more gradual glucose-lowering effect. The two products serve complementary roles in a basal-bolus insulin regimen.
Humalog Basal is available as a suspension for injection in 3 mL cartridges (100 IU/mL) for use with compatible reusable pen devices, and in pre-filled disposable KwikPen devices. The suspension should appear uniformly cloudy or milky white after proper resuspension. If it appears clear, contains clumps, or has particles sticking to the cartridge wall, it should not be used.
What Should You Know Before Taking Humalog Basal?
Before starting Humalog Basal, you must inform your doctor about all medical conditions, other medications, and whether you are pregnant or breastfeeding. Certain conditions and medications can significantly affect how insulin works and may require dose adjustments or additional monitoring.
Contraindications
Humalog Basal must not be used in the following situations:
- Hypoglycaemia: Do not inject Humalog Basal if your blood sugar is already low (hypoglycaemia). Treat the low blood sugar first before administering your next insulin dose.
- Allergy: Do not use if you are allergic to insulin lispro, protamine, or any of the other ingredients in the formulation (including metacresol, phenol, glycerol, zinc oxide, dibasic sodium phosphate, or water for injection).
- Intravenous administration: Humalog Basal must never be administered intravenously. It is a suspension that is designed exclusively for subcutaneous injection.
- Use in insulin pumps: Humalog Basal must not be used in external or implanted insulin infusion pumps. Only rapid-acting clear insulin formulations are suitable for pump use.
Warnings and Precautions
Discuss the following with your doctor before using Humalog Basal:
- Hypoglycaemia risk: Hypoglycaemia (low blood sugar) is the most common and potentially serious adverse effect of insulin therapy. Symptoms include sweating, trembling, hunger, confusion, dizziness, palpitations, and visual disturbances. Severe hypoglycaemia can lead to loss of consciousness, seizures, and death if untreated. Always carry a source of fast-acting sugar.
- Renal impairment: Kidney disease can reduce insulin clearance, potentially increasing the risk of hypoglycaemia. Dose reductions and more frequent blood glucose monitoring may be needed.
- Hepatic impairment: Liver disease can affect glucose regulation and insulin metabolism. Insulin requirements may be reduced, and closer monitoring is advised.
- Injection site rotation: Always rotate injection sites within the same body region (abdomen, thigh, or upper arm) to reduce the risk of lipodystrophy (thickening or pitting of fat tissue) and cutaneous amyloidosis (protein deposits under the skin), which can affect insulin absorption.
- Illness and stress: Infections, fever, trauma, surgery, and emotional stress can increase insulin requirements. Monitor blood glucose more frequently during illness and adjust doses as directed by your healthcare provider.
- Alcohol: Alcohol can intensify and prolong the glucose-lowering effect of insulin, increasing the risk of hypoglycaemia. Drink alcohol with caution and always with food.
- Driving and operating machinery: Hypoglycaemia can impair concentration and reaction time. Check your blood glucose before driving and carry glucose tablets. Do not drive if your blood sugar is low.
- Thiazolidinediones (glitazones): Concurrent use with pioglitazone or rosiglitazone may increase the risk of fluid retention and heart failure. Inform your doctor if you experience signs such as shortness of breath, rapid weight gain, or swollen ankles.
Pregnancy and Breastfeeding
Good glycaemic control is essential during pregnancy to reduce risks to both mother and baby. If you are pregnant, planning to become pregnant, or breastfeeding, discuss insulin management with your doctor. Key considerations include:
- Pregnancy: There are no adequate controlled clinical trials of Humalog Basal in pregnant women. Animal studies have not shown direct harmful effects on embryonic or foetal development at standard doses. However, insulin requirements typically decrease during the first trimester and increase during the second and third trimesters. Close monitoring and dose adjustments are essential throughout pregnancy.
- Breastfeeding: Insulin lispro is excreted in breast milk in small amounts. Insulin is a naturally occurring peptide that is degraded in the infant's gastrointestinal tract and is not absorbed intact. Therefore, Humalog Basal is generally considered compatible with breastfeeding. Insulin dose adjustments and dietary modifications may be necessary during lactation.
- Fertility: Animal studies have not shown any adverse effects of insulin lispro on fertility at therapeutic doses.
How Does Humalog Basal Interact with Other Drugs?
Many medications can affect blood sugar levels and may require adjustments to your Humalog Basal dose. It is critical to inform your doctor and pharmacist about all prescription and over-the-counter medicines, supplements, and herbal products you are taking.
Drug interactions with insulin are clinically important because they can either increase or decrease blood glucose levels, potentially leading to hypoglycaemia or hyperglycaemia. Some interactions require dose adjustments, while others may necessitate more frequent blood glucose monitoring. The following tables summarise the most significant interactions.
Medications That Increase Hypoglycaemia Risk
These medications can enhance the glucose-lowering effect of insulin and increase the risk of hypoglycaemia. Dose reductions and more frequent monitoring may be required when these drugs are initiated, changed, or discontinued.
| Drug / Drug Class | Mechanism | Clinical Significance |
|---|---|---|
| Oral antidiabetic agents (metformin, sulfonylureas, SGLT2 inhibitors, DPP-4 inhibitors, GLP-1 agonists) | Additive glucose-lowering effect through complementary mechanisms | High — dose adjustment of insulin often required when combination therapy is initiated or changed |
| ACE inhibitors (e.g., ramipril, enalapril, lisinopril) | Improved insulin sensitivity and reduced insulin degradation | Moderate — monitor blood glucose when starting or stopping |
| MAO inhibitors | Enhanced insulin secretion and reduced hepatic gluconeogenesis | High — significant hypoglycaemia risk; close monitoring essential |
| Beta-blockers (e.g., propranolol, atenolol, metoprolol) | May mask hypoglycaemia symptoms (tremor, tachycardia); can impair glycogenolysis | High — cardioselective beta-blockers are preferred in diabetes; monitor closely |
| Salicylates (high-dose aspirin) | Increased insulin secretion and enhanced peripheral glucose utilisation | Moderate — relevant mainly at anti-inflammatory doses (>3 g/day) |
| Fibrates (e.g., fenofibrate, gemfibrozil) | Improved insulin sensitivity | Low to moderate — monitor glucose levels |
| Alcohol | Inhibits hepatic gluconeogenesis; delayed and prolonged hypoglycaemia risk | High — especially dangerous when consumed without food or in excess |
Medications That May Reduce Insulin Effectiveness
These medications can raise blood glucose levels and may necessitate an increase in insulin dose. Blood glucose should be monitored more frequently when any of these medications are started, changed, or stopped.
| Drug / Drug Class | Mechanism | Clinical Significance |
|---|---|---|
| Corticosteroids (e.g., prednisolone, dexamethasone, hydrocortisone) | Increase hepatic glucose production and reduce peripheral insulin sensitivity | High — significant hyperglycaemia; insulin dose increase often needed, especially with systemic steroids |
| Thiazide diuretics (e.g., hydrochlorothiazide, bendroflumethiazide) | Impaired insulin secretion and increased insulin resistance | Moderate — dose-dependent; monitor glucose when initiating therapy |
| Thyroid hormones (e.g., levothyroxine) | Increased hepatic glucose production and intestinal glucose absorption | Moderate — monitor glucose when thyroid function changes or thyroid medication is adjusted |
| Sympathomimetics (e.g., salbutamol, terbutaline, epinephrine) | Stimulate glycogenolysis and gluconeogenesis via beta-adrenergic activation | Moderate — particularly relevant with systemic use |
| Oral contraceptives / Oestrogens | Reduced insulin sensitivity | Low to moderate — modern low-dose formulations have less impact |
| Atypical antipsychotics (e.g., olanzapine, clozapine, quetiapine) | Insulin resistance, weight gain, and impaired glucose tolerance | High — significant metabolic effects; regular glucose monitoring recommended |
| Protease inhibitors (e.g., ritonavir, lopinavir) | Insulin resistance and impaired glucose tolerance | Moderate — monitor glucose in HIV patients on antiretroviral therapy |
What Is the Correct Dosage of Humalog Basal?
Humalog Basal dosing is highly individualised based on the patient's metabolic needs, blood glucose monitoring results, and glycaemic targets. Doses are prescribed by a physician and adjusted regularly. The typical starting dose is 10 units once or twice daily for type 2 diabetes, while type 1 diabetes requires total daily insulin doses calculated at 0.5–1.0 IU/kg/day.
Insulin dosing is one of the most individualised aspects of diabetes management. There is no single correct dose of Humalog Basal — the right dose is the one that achieves your blood glucose targets while minimising the risk of hypoglycaemia. Your doctor will determine your starting dose based on factors including your type of diabetes, body weight, level of physical activity, dietary habits, concomitant medications, and individual sensitivity to insulin.
Humalog Basal is administered by subcutaneous injection only, typically once or twice daily. It should be injected into the abdomen, thigh, or upper arm, and injection sites should be rotated within the same body region to prevent lipodystrophy. The suspension must be gently resuspended (rolled and inverted) before every injection until uniformly cloudy.
Adults
Type 2 Diabetes — Starting Dose
The typical starting dose is 10 units once daily, usually at bedtime. The dose is then titrated (adjusted) every 3–7 days based on fasting blood glucose levels, typically by 2–4 units per adjustment, until the target fasting glucose of 4.0–7.0 mmol/L (72–126 mg/dL) is achieved. Some patients may require twice-daily dosing (morning and bedtime).
Type 1 Diabetes — Basal-Bolus Regimen
Total daily insulin requirement is typically 0.5–1.0 IU/kg/day, with approximately 40–50% given as basal insulin (Humalog Basal) and the remainder as rapid-acting insulin at mealtimes. For example, a 70 kg patient requiring 0.7 IU/kg/day (49 IU total) might receive approximately 20–25 units of Humalog Basal and the balance as mealtime rapid-acting insulin divided across meals.
Children and Adolescents
Paediatric Dosing (Age 2 Years and Older)
Humalog Basal may be used in children aged 2 years and above. Paediatric insulin requirements vary considerably by age and pubertal stage. Prepubertal children typically require 0.7–1.0 IU/kg/day total insulin, while adolescents during puberty may need 1.0–2.0 IU/kg/day due to growth hormone-mediated insulin resistance. Basal insulin generally constitutes 30–50% of total daily insulin. Dosing must be determined by a paediatric endocrinologist, and parents or carers should be trained in insulin administration, dose adjustment, and hypoglycaemia management.
Elderly Patients
Dosing in Older Adults (Age 65 Years and Older)
Older adults may have reduced renal function, altered counterregulatory hormone responses, and reduced awareness of hypoglycaemia symptoms. Initial doses should be conservative, and dose titration should be slower and more cautious. Glycaemic targets may be relaxed (e.g., HbA1c < 8.0% or 64 mmol/mol) to minimise the risk of severe hypoglycaemia. Regular monitoring of renal function and more frequent blood glucose checks are recommended. Medication reviews should be conducted regularly to assess the continued need for and safety of the prescribed regimen.
Missed Dose
If you miss a dose of Humalog Basal:
- Take the missed dose as soon as you remember, unless it is nearly time for your next scheduled dose.
- Never take a double dose to make up for a missed one — this can cause dangerous hypoglycaemia.
- Check your blood glucose level immediately and at regular intervals afterwards.
- If you are unsure about what to do, contact your doctor, diabetes nurse, or pharmacist.
- If you frequently miss doses, discuss strategies with your healthcare team to improve adherence, such as setting reminders or adjusting injection times.
Overdose
An insulin overdose causes hypoglycaemia, which can range from mild (sweating, trembling, hunger) to severe (confusion, seizures, loss of consciousness, coma). The severity depends on the degree of overdose relative to the patient's food intake and activity level.
Mild hypoglycaemia: Treat immediately with 15–20 grams of fast-acting carbohydrate (e.g., glucose tablets, fruit juice, regular soft drink). Recheck blood glucose after 15 minutes and repeat if necessary. Follow up with a complex carbohydrate snack to prevent recurrence.
Severe hypoglycaemia (unconsciousness or inability to swallow): Do not attempt to give anything by mouth. Administer glucagon injection (if available and trained) and place the person in the recovery position. Call emergency services immediately. Intravenous glucose will be administered by healthcare professionals on arrival.
Always seek medical attention after a severe hypoglycaemic episode, even if recovery seems complete, as recurrent hypoglycaemia can occur.
What Are the Side Effects of Humalog Basal?
Like all insulins, Humalog Basal can cause side effects. The most common is hypoglycaemia (low blood sugar). Injection site reactions, lipodystrophy, and weight gain are also frequently reported. Most side effects are manageable with proper monitoring and technique, but severe allergic reactions require immediate medical attention.
Side effects of insulin therapy are well characterised from extensive clinical experience spanning decades. The frequency categories below are based on data from clinical trials and post-marketing surveillance reported to regulatory agencies including the EMA and FDA. Not everyone will experience side effects, and many can be minimised through proper injection technique, site rotation, and blood glucose monitoring.
Very Common (affects more than 1 in 10 people)
- Hypoglycaemia — sweating, trembling, dizziness, hunger, confusion, palpitations, visual disturbances, difficulty concentrating
Common (affects 1 in 10 to 1 in 100 people)
- Injection site reactions — redness, swelling, itching, pain, or bruising at the injection site
- Lipodystrophy — localised thickening (lipohypertrophy) or thinning (lipoatrophy) of subcutaneous fat tissue at frequently used injection sites
- Weight gain — insulin is an anabolic hormone that promotes fat and glycogen storage
- Peripheral oedema — fluid retention, especially when insulin therapy is first initiated or during intensification (transient)
Uncommon (affects 1 in 100 to 1 in 1,000 people)
- Local allergic reactions — erythema, urticaria, or pruritus extending beyond the immediate injection site
- Cutaneous amyloidosis — protein deposits under the skin at injection sites, potentially affecting insulin absorption
- Visual disturbances — transient blurred vision or changes in visual acuity, particularly when starting insulin therapy or during rapid blood glucose changes
Rare (affects fewer than 1 in 1,000 people)
- Systemic allergic reactions (anaphylaxis) — generalised skin rash, angioedema, bronchospasm, hypotension, tachycardia; this is a medical emergency requiring immediate treatment with epinephrine
- Insulin antibody formation — development of antibodies to insulin lispro, which may occasionally necessitate dose adjustments to correct hyper- or hypoglycaemia
- Insulin neuritis — painful neuropathy occurring with rapid improvement in glycaemic control, particularly in patients with previously very high HbA1c; typically self-limiting
Contact emergency services immediately if you experience signs of a severe allergic reaction: widespread skin rash or hives, swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, rapid heartbeat, or feeling faint. Severe hypoglycaemia (loss of consciousness, seizures) also requires emergency treatment.
How Should You Store Humalog Basal?
Unopened Humalog Basal should be stored in a refrigerator at 2–8°C (36–46°F). Once in use, it can be kept at room temperature (below 30°C / 86°F) for up to 28 days. Never freeze insulin, and always protect it from direct heat and sunlight.
Proper storage of insulin is essential for maintaining its potency and ensuring safe, effective treatment. Improperly stored insulin may lose its effectiveness, potentially leading to poor glycaemic control and hyperglycaemia. Humalog Basal is a protamine-suspended insulin and has specific storage requirements that differ slightly from clear insulin solutions.
- Before first use (unopened): Store in a refrigerator at 2–8°C (36–46°F). Keep in the original outer carton to protect from light. Do not store near the freezer compartment. Insulin that has been frozen must be discarded and never used.
- After first use (in-use): The cartridge or KwikPen can be kept at room temperature (below 30°C / 86°F) for up to 28 days. Do not refrigerate the pen you are currently using, as cold insulin can be painful to inject and may affect absorption. After 28 days, discard any remaining insulin even if the cartridge is not empty.
- Protection: Keep away from direct sunlight and heat sources such as radiators, car dashboards, and windowsills. Do not leave insulin in a hot car. When travelling, carry insulin in an insulated bag with a cool pack (but ensure it does not freeze).
- Inspection before use: Before each injection, roll and invert the cartridge as directed. After resuspension, the insulin should appear uniformly cloudy or milky white. Do not use if it appears clear, contains visible particles or clumps, or if white material adheres to the cartridge wall.
- Disposal: Used needles should be placed in an approved sharps disposal container. Expired or damaged insulin pens and cartridges should be returned to a pharmacy for safe disposal according to local regulations.
When travelling by air, always carry your insulin in your hand luggage — never in checked baggage, as the cargo hold temperature can drop well below freezing at altitude. Carry a letter from your doctor confirming your need for insulin and injection supplies to facilitate security screening. Keep a supply of glucose tablets and a glucagon emergency kit in your hand luggage as well.
What Does Humalog Basal Contain?
Each millilitre of Humalog Basal suspension contains 100 IU of insulin lispro protamine (equivalent to 3.5 mg) as the active ingredient, along with several inactive excipients that maintain the stability, sterility, and proper pH of the formulation.
Understanding the complete composition of your medication is important, particularly if you have known allergies or sensitivities to any pharmaceutical ingredients. The full composition of Humalog Basal 100 IU/mL suspension for injection is as follows:
- Active ingredient: Insulin lispro protamine — 100 IU/mL (3.5 mg/mL). Insulin lispro is produced by recombinant DNA technology in Escherichia coli and then complexed with protamine sulfate to create the intermediate-acting suspension.
- Protamine sulfate: A positively charged protein derived from fish sperm that binds to insulin lispro, creating crystals that dissolve slowly after subcutaneous injection, thereby prolonging the duration of action. Patients with fish allergies should discuss this with their doctor, although protamine is highly purified and clinically significant allergic reactions are rare.
- Metacresol: An antimicrobial preservative (3.15 mg/mL) that maintains the sterility of the multi-dose formulation during the 28-day in-use period.
- Phenol: An additional antimicrobial preservative (1.00 mg/mL) providing complementary antimicrobial activity.
- Glycerol: A tonicity modifier that ensures the suspension is isotonic with body fluids, reducing pain on injection.
- Zinc oxide: Contributes to the formation and stability of insulin crystals within the suspension. Trace amounts of zinc are present in the final product.
- Dibasic sodium phosphate 7H2O: A buffering agent that maintains the pH of the suspension within the optimal range (approximately pH 7.0–7.8).
- Water for injection: The vehicle for the suspension.
- Hydrochloric acid and/or sodium hydroxide: Used during manufacture for pH adjustment; present only as trace residues.
Humalog Basal does not contain latex in the vial stopper, cartridge plunger, or pen components. Each 3 mL cartridge contains 300 IU of insulin lispro protamine in total.
Frequently Asked Questions About Humalog Basal
Humalog Basal (insulin lispro protamine) is used to control blood sugar levels in people with type 1 and type 2 diabetes mellitus. It is an intermediate-acting insulin that provides basal (background) insulin coverage for up to 24 hours, helping to maintain stable blood glucose levels between meals and overnight. In type 1 diabetes it is used alongside rapid-acting mealtime insulin, while in type 2 diabetes it may be used alone or combined with oral antidiabetic medications.
Regular Humalog (insulin lispro) is a rapid-acting insulin taken at mealtimes with an onset within 15 minutes and duration of 2–5 hours. Humalog Basal (insulin lispro protamine) is an intermediate-acting insulin with onset in 1–2 hours, peak effect at 4–12 hours, and duration up to 24 hours. The key difference is the addition of protamine, which delays insulin absorption and provides longer-lasting background glycaemic control rather than mealtime coverage.
No. Humalog Basal should not be mixed with other insulin preparations in the same cartridge, pen, or syringe. If your treatment plan requires both basal and rapid-acting insulin, they should be given as separate injections at different injection sites. Always follow your healthcare provider's specific instructions regarding your insulin regimen.
An overdose of insulin causes hypoglycaemia (low blood sugar). For mild symptoms (sweating, trembling, hunger, dizziness), immediately eat or drink 15–20 grams of fast-acting carbohydrate such as glucose tablets or fruit juice. Check your blood sugar after 15 minutes and repeat if needed. For severe hypoglycaemia with confusion, seizures, or loss of consciousness, do not give anything by mouth — administer glucagon if available and call emergency services immediately.
Store unopened Humalog Basal in a refrigerator at 2–8°C (36–46°F). Do not freeze. Once in use, the cartridge or KwikPen can be kept at room temperature (below 30°C / 86°F) for up to 28 days. After 28 days, discard any remaining insulin even if the pen is not empty. Protect from direct sunlight and heat. Always inspect the insulin before use — it should appear uniformly cloudy after resuspension.
Humalog Basal is a suspension, not a solution. The cloudiness is caused by the insulin lispro protamine crystals that are suspended in the liquid. These crystals dissolve slowly after injection, which is what gives the insulin its intermediate-acting profile. Before each injection, you must gently roll and invert the cartridge to evenly resuspend the crystals. If the insulin remains clear or has visible clumps after resuspension, do not use it.
References
- European Medicines Agency (EMA). Humalog — Summary of Product Characteristics. Available at: www.ema.europa.eu/en/medicines/human/EPAR/humalog. Last updated 2024.
- U.S. Food and Drug Administration (FDA). Humalog Prescribing Information. Eli Lilly and Company. Revised 2024.
- American Diabetes Association (ADA). Standards of Care in Diabetes — 2024. Diabetes Care. 2024;47(Supplement 1):S1–S321. doi:10.2337/dc24-SINT.
- Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022;65(12):1925–1966. doi:10.1007/s00125-022-05787-2.
- World Health Organization (WHO). Model List of Essential Medicines — 23rd List (2023). Geneva: WHO; 2023. Insulin preparations are included as essential medicines.
- National Institute for Health and Care Excellence (NICE). Type 1 diabetes in adults: diagnosis and management [NG17]. Updated 2022. Available at: www.nice.org.uk/guidance/ng17.
- National Institute for Health and Care Excellence (NICE). Type 2 diabetes in adults: management [NG28]. Updated 2022. Available at: www.nice.org.uk/guidance/ng28.
- International Society for Pediatric and Adolescent Diabetes (ISPAD). Clinical Practice Consensus Guidelines 2022. Pediatric Diabetes. 2022;23(8):1001–1284.
- British National Formulary (BNF). Insulin lispro. Available at: bnf.nice.org.uk/drugs/insulin-lispro. Accessed December 2025.
- Rosenstock J, Schwartz SL, Clark CM Jr, et al. Basal insulin therapy in type 2 diabetes: 28-week comparison of insulin glargine (HOE 901) and NPH insulin. Diabetes Care. 2001;24(4):631–636.
Editorial Team
This article has been written and medically reviewed by the iMedic Medical Editorial Team, comprising specialist physicians in endocrinology, diabetology, and clinical pharmacology. Our editorial process follows international standards for medical content, including the GRADE evidence framework and adherence to guidelines from the ADA, EASD, EMA, and WHO.
iMedic Medical Editorial Team
Specialists in Endocrinology and Clinical Pharmacology
iMedic Medical Review Board
Independent expert panel following EMA and FDA guidelines
Level 1A — Systematic reviews and randomised controlled trials
GRADE evidence framework
None declared. No pharmaceutical industry funding or sponsorship.